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[The usefulness of serum creatinine levels in identifying hospital malnutrition]
M Ballesteros1, A Cortes, C I Arleaga
1Departamento de Anestesiología y Cuidado Intensivo, Universidad de Justus-Liebig, Giessen, RFA.
Purpose:
to determine the diagnostic accuracy of seric creatinine in the depletion of the somatic compartment and in adult malnutrition.
Design:
a prospective study.
Place:
a tertiary care centre.
Patients:
140 subjects evaluated by the nutritional support group.
Exclusion Criteria:
kidney insufficiency, immune-suppression, malignant illness, sepsis and multisystemic organ failure.
Procedures:
appraisal of the somatic compartment (weight deficiency percentage, arm muscle circumference, cutaneous triceps fold an twenty-four hour creatinuria) and the visceral compartment (series albumin and lymphocyte count). Calculation of derived variables.
Main Results:
74% of patients had creatinine levels of 0.8 mg% or less and, of them, 79% were malnourished. The diagnostic acuteness of seric creatinine levels of this limit or lower is 73% for somatic compartment deficiency, and 75% for some degree of malnutrition. There is a significant negative correlation between the absolute value of the cutaneous triceps fold and seric creatinine levels.
Conclusions:
seric creatinine levels of 0.8 mg% in hospitalized patients suggest a somatic deficiency. The presence of this parameter within these limits makes it highly advisable to carry out a complete nutritional evaluation. However, these values should not be considered an irrefutable indicator of adult malnutrition. Seric creatinine levels analyzed together with the tricipital cutaneous fold values serve to identify depletion of the somatic compartment to the greater detriment of the fat component than the muscular component.